β‐blocker therapy for mitral stenosis is controversial. This study compares right and left heart hemodynamics at rest and supine submaximal exercise in patients (n = 7) receiving chronic β‐antagonists with untreated patients (n = 17) matched for age (mean ± SD = 51 ± 12 years) and valve area (0.7 ± 0.2 cm2/m2). Little benefit was observed with treatment at rest. Although pulmonary capillary wedge pressures (PCWP) were lower during exercise in the β‐blocker group (22±4 vs. 31 ± 9 mmHg; P>0.05), exercise performance was not enhanced and cardiac output response during exercise was reduced (control = 41% increase vs. 12% for β‐blockade). PCWP rose rapidly when diastolic filling periods were >300 msec in both groups. Pulmonary capillary wedge pressure was found to be a nonlinear functions (P<0.001) of diastolic filling period (PCWP = 15.9 + 5.84 × 105/dfp2). These data suggest that there is a critical heart rate in patients with mitral stenosis above which hemodynamic compromise rapidly occurs. © 1995 Wiley‐Liss, Inc.
- cardiac catheterization
- heart rate
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine